Birth Control and Safer Sex: Common Questions

Talking about birth control and sexually transmitted infection (STI) prevention may not be most people’s idea of a super-fun conversation. All the same, these are topics that most of us need to be informed about.

We may wish that this wasn’t the case, but it is. So, unless you are active with one partner only, you are both faithful to each other, and you know from testing that you have no STIs (remember, STIs can take weeks to months to show up), use a condom or a female condom…or don’t be sexually active.

Which birth control methods are most effective?

The IUD, the implant, and vasectomy or sterilization are most effective at preventing pregnancy. These methods have very little room for “user error.”

If these options aren’t right for you, another choice for increased efficacy is to “double up”—for instance, to use a condom with another method, such as the pill, sponge, or diaphragm.

Which birth control methods are cheapest?

Under the current terms of the Affordable Care Act, women with health insurance coverage should be able to obtain most kinds of birth control for free or close to it. However, it is possible that this will change in the future due to changes in legislation. Free and low-cost birth control is also often available at community clinics.

If you are buying birth control out of pocket (without health insurance), then condoms, diaphragms, and cervical caps can all be pretty affordable options. An IUD is also inexpensive over the long run because it lasts so long, but it has a high upfront cost. Fertility awareness is free or very cheap, but requires a lot of care and knowledge. If you are ready to decide that fertility is no longer desirable, sterilization may be costly upfront, but lasts a lifetime.

In part, your “cheapest” option will depend on how often you are needing to use birth control. For some people, occasionally buying condoms will work and be very inexpensive, while others need a method that is “always on.”

Which methods of birth control can be obtained without visiting a doctor?

Condoms, female condoms, the sponge, spermicide, and fertility awareness…along with, of course, the withdrawal method. Many methods of emergency contraception are also available over the counter.

What do LGBT people need to know about these topics?

STI prevention is relevant to all people who are sexually active. Anyone who has oral, anal or vaginal sex or genital contact with another person can contract an STI.

Men who have sex with men need to know about condom use. Those who engage in oral sex with women or analingus (“rimming”) need to know about dental dams.

Also, it may seem obvious, but anyone engaging in penis-in-vagina sex should use birth control, regardless of sexual identity. And trans people who are taking hormones may still be fertile.

Are any new kinds of birth control being developed?

Although it’s great that we already have many methods of birth control available to us, no one could be blamed for wishing there were more options, especially for men. Is anything new on the horizon? Yes. Researchers are looking at injectable birth control for men (the injection “neutralizes” sperm and can be reversed with a second shot) as well as hormonal gel for men. A vaginal ring that only needs to be changed once a year is also in development.

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